Selamat tahun baru, semoga tahun ini bisa jadi tahun kebangkitan
dokter Indonesia di negerinya sendiri, kembali mendapatkan kepercayaan
yang tinggi dari masyarakat khususnya kalangan menengah ke atas. Ini
nggak akan datang dengan sendirinya, harus dibarengi dengan kerja
keras & kerja tim di antara kita.
Nah, apa mungkin itu bisa dipenuhi jika kita melakukan sesuatu semata
demi uang tanpa ada dasar ilmiahnya? Apa masih pantas profesi kita
disebut 'dokter'? Apa mau kita terus jadi 'mesin uang' dari para
pengusaha (bagi rekan-rekan yang praktik di institusi bisnis)?
Hospitals are making room for alternative therapies
More hospitals offer alternative treatments such as acupuncture and
massage. Patient demand and profit are among the reasons, though many
of the therapies have not been proved scientifically.
As hospitals elbow one another to attract patients, increasingly
they're hoping to tap into Americans' interest in — and willingness to
spend money on — complementary and alternative therapies such as
acupuncture and massage.
According to a recent survey by the American Hospital Assn. and the
Samueli Institute, a nonprofit research group focusing on
complementary medicine, 42% of the 714 hospitals that responded
offered at least one such therapy in 2010; five years earlier, only
27% of hospitals offered such treatments.
Experts say hospitals are embracing these therapies for many reasons,
including a growing recognition that some integrative therapies, as
they're also called, are very effective in certain instances.
In addition, hospitals aren't blind to the opportunity these therapies
present to attract patients and perhaps make some money. According to
the most recent report from the National Center for Health Statistics,
Americans spent $33.9 billion on integrative therapies in 2007 — with
most of the money coming out of their own pockets, since the majority
of these treatments aren't covered by insurance. That figure includes
fees for about 354 million visits to complementary and alternative
medical practitioners, and it represents about 11% of total
out-of-pocket expenditures on healthcare.
Hospitals offer most of their integrative therapies on an outpatient
basis, usually at designated centers at or near the hospitals. The
treatments are typically aimed at relieving symptoms of serious or
chronic illness: A physician might prescribe acupuncture to a patient
battling nausea caused by chemotherapy, for example, or recommend
massage or meditation to help reduce anxiety and stress.
Although research supporting the efficacy of complementary therapies
is increasing, hospitals wouldn't have much to offer if they confined
themselves to procedures supported by medical evidence, says Ian
Coulter, a senior health policy analyst at the Rand Corp. in Santa
Monica. So hospitals pick and choose, based on what they judge to be
most effective and what they believe patients want.
Indeed, patient demand dictates the types of treatments hospitals
choose to offer, says survey designer Sita Ananth, director of
knowledge services at the Samueli Institute in Alexandria, Va.
According to the survey, the top treatments offered at outpatient
centers were massage therapy, acupuncture and guided imagery. (The
latter uses mental techniques, including visualization, to achieve
such goals as reducing stress.)
On an inpatient basis, the top offerings are therapy with pets,
massage and music/art therapy, according to the survey.
Over the last decade, Grinnell Regional Medical Center, a rural
community hospital in Grinnell, Iowa, has built a comprehensive
integrative therapy program that offers inpatient services as well as
an array of treatments at its outpatient center six blocks away.
"We're looking for ways to improve the patient experience and to
improve outcomes," says Todd Linden, president and chief executive of
the medical center. For example, patients awaiting surgery are offered
a 10- to 15-minute massage to help reduce anxiety. After a massage,
"IVs go in easier, people come out of anesthesia quicker and some
physicians say their patients have less pain," he says.
That's good for patients, but Linden says it should also help the
hospital's bottom line. For example, if these interventions help
shorten a Medicare patient's hospital stay, the hospital can keep a
bigger chunk of the preset payment for a given illness or injury.
And as providers increasingly become part of accountable care
organizations, in which they're paid to take responsibility for a
patient's overall health rather than provide services a la carte, "we
need to add new core competencies … like keeping people healthy," he
says. Integrative therapies are part of that strategy.
Debby Pohlson, 59, has been going to Grinnell's outpatient facility
for acupuncture treatments for six years. For most of her life,
Pohlson has suffered from irritable bowel syndrome, a condition that
causes painful abdominal cramping along with constipation and
diarrhea. Conventional medicine hadn't helped, so when her husband
brought home a brochure describing the acupuncture services at the
outpatient center, she decided to give it a try.
It took a few months of weekly hourlong treatments to see results, but
gradually her painful, unpredictable symptoms abated. Now Pohlson, who
is on the hospital's board of trustees, returns every three or four
weeks to have small needles placed around her navel, below her knees,
at the back of her head and elsewhere. Except for occasional
flare-ups, her condition is now under control.
The couple's insurance doesn't cover her treatments, but they deposit
enough in their flexible spending account every year to cover the $55
sessions with pretax money. Meanwhile, Pohlson's quality of life has
improved tremendously. "Now I can eat out without fear," she says.
Despite her positive experience, research hasn't found evidence that
acupuncture improves irritable-bowel symptoms.
For their part, hospitals find that patients are pleased to have the
option of using alternative therapies, and that is often reason enough
to offer the services. The hospital survey found that patient
satisfaction was the No. 1 measure used to evaluate the success of a
hospital's complementary and alternative medicine program, cited by
85% of respondents. Only 42% said they were using health outcomes to
measure the success of their programs.